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General NPI Number Information
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NPI Number | 1447508882
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Entity Type | Organization
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Legal Business Name | KEYSTONE COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 4155 N RANCHO DR STE 120
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City | LAS VEGAS
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State | NV
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Zip | 89130-3448
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Country | US
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Telephone | 702-546-6214
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Fax |
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Provider Business Mailing Address
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Address Line | 10637 STRAND CITY AVE
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City | LAS VEGAS
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State | NV
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Zip | 89166-7131
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Country | US
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Telephone | 702-546-6214
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. HANNAH S BRADLEY
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Credential | LMFT
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Telephone | 702-546-6214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MI0248
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License Number State | NV
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